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Pain in Autism Spectrum Disorders

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Encyclopedia of Autism Spectrum Disorders

Definition: Pain

Pain refers to “an unpleasant sensory and emotional experience associated with actual or potential tissue damage.” It is important therefore to understand that pain is more than a simple “ouch” and refers to the emotional, cognitive, and social aspects associated with potentially noxious physical sensations. Therefore, the current entry will focus on responses to tactile, thermal, and chemical stimuli which have the potential to result in unpleasant sensations. This entry will not consider distressing responses to emotional or other sensory experiences; for a review of these, see the entry “Sensory Processing”.

To understand both the experience of pain, the expression of pain, and the relationship of these to ASD, it is also important to consider the process by which pain is perceived and then communicated. When considering painful events that start in the periphery (e.g., pain resulting from an injury/tissue damage), it is often possible to see the noxious input,...

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References and Reading

  • Bandstra, N. F., Johnson, S. A., Filliter, J. H., & Chambers, C. T. (2012). Self-reported and parent-reported pain for common painful events in high-functioning children and adolescents with autism spectrum disorder. The Clinical Journal of Pain, 28(8), 715–721. https://doi.org/10.1097/AJP.0b013e318243ecf6.

    Article  Google Scholar 

  • Becker, J. A., Clesse, D., Spiegelhalter, C., Schwab, Y., Le Merrer, J., & Kieffer, B. L. (2014). Autistic-like syndrome in mu opioid receptor null mice is relieved by facilitated mGluR4 activity. Neuropsychopharmacology, 39, 2049.

    Article  Google Scholar 

  • Bursch, B., Ingman, K., Vitti, L., Hyman, P., & Zeltzer, L. K. (2004). Chronic pain in individuals with previously undiagnosed autistic spectrum disorders. The Journal of Pain, 5(5), 290–295. https://doi.org/10.1016/j.jpain.2004.04.004.

    Article  PubMed  Google Scholar 

  • Duerden, E. G., Card, D., Roberts, S. W., Mak-Fan, K. M., Chakravarty, M. M., Lerch, J. P., & Taylor, M. J. (2014). Self-injurious behaviours are associated with alterations in the somatosensory system in children with autism spectrum disorder. Brain Structure and Function, 219(4), 1251–1261.

    Article  Google Scholar 

  • Failla, M. D., Moana-Filho, E. J., Essick, G. K., Baranek, G. T., Rogers, B. P., & Cascio, C. J. (2018). Initially intact neural responses to pain in autism are diminished during sustained pain. Autism, 22(6), 669–683.

    Article  Google Scholar 

  • Failla, M. D., Schwartz, K. L., Chaganti, S., Cutting, L. E., Landman, B. A., & Cascio, C. J. (2019). Characterizing co-occurring conditions by age at diagnosis in autism spectrum disorders. medRxiv:19002527.

    Google Scholar 

  • Garcia-Villamisar, D., Moore, D., & Garcia-Martínez, M. (2019). Internalizing symptoms mediate the relation between acute pain and autism in adults. Journal of Autism and Developmental Disorders, 49(1), 270–278.

    Article  Google Scholar 

  • Gilbert-MacLeod, C. A., Craig, K. D., Rocha, E. M., & Mathias, M. D. (2000). Everyday pain responses in children with and without developmental delays. Journal of Pediatric Psychology, 25(5), 301–308. https://doi.org/10.1093/jpepsy/25.5.301.

    Article  PubMed  Google Scholar 

  • Gillberg, C., Terenius, L., & Lönnerholm, G. (1985). Endorphin activity in childhood psychosis: Spinal fluid levels in 24 cases. Archives of General Psychiatry, 42(8), 780–783. https://doi.org/10.1001/archpsyc.1985.01790310042005.

    Article  PubMed  Google Scholar 

  • Gu, X., Zhou, T. J., Anagnostou, E., Soorya, L., Kolevzon, A., Hof, P. R., & Fan, J. (2018). Heightened brain response to pain anticipation in high-functioning adults with autism spectrum disorder. European Journal of Neuroscience, 47, 592–601.

    Article  Google Scholar 

  • Hadjikhani, N., Zürcher, N., Rogier, O., Hippolyte, L., Lemonnier, E., Ruest, T., … Billstedt, E. (2014). Emotional contagion for pain is intact in autism spectrum disorders. Translational Psychiatry, 4(1), e343.

    Article  Google Scholar 

  • Han, Q., Kim, Y. H., Wang, X., Liu, D., Zhang, Z.-J., Bey, A. L., Lay, M., Chang, W., Berta, T., Zhang, Y., Jiang, Y.-H., & Ji, R.-R. (2016). SHANK3 deficiency impairs heat hyperalgesia and TRPV1 signaling in primary sensory neurons. Neuron, 92, 1279–1293.

    Article  Google Scholar 

  • Krach, S., Kamp-Becker, I., Einhäuser, W., Sommer, J., Frässle, S., Jansen, A., Rademacher, L., Müller-Pinzler, L., Gazzola, V., & Paulus, F. M. (2015). Evidence from pupillometry and fMRI indicates reduced neural response during vicarious social pain but not physical pain in autism. Human Brain Mapping, 36, 4730–4744.

    Article  Google Scholar 

  • Lipsker, C. W., Bölte, S., Hirvikoski, T., Lekander, M., Holmström, L., & Wicksell, R. K. (2018). Prevalence of autism traits and attention-deficit hyperactivity disorder symptoms in a clinical sample of children and adolescents with chronic pain. Journal of Pain Research, 11, 2827.

    Article  Google Scholar 

  • Minshew, N., & Hobson, J. (2008). Sensory sensitivities and performance on sensory perceptual tasks in high-functioning individuals with autism. Journal of Autism and Developmental Disorders, 38(8), 1485–1498. https://doi.org/10.1007/s10803-007-0528-4.

    Article  PubMed  PubMed Central  Google Scholar 

  • Richdale, A. L., & Schreck, K. A. (2009). Sleep problems in autism spectrum disorders: prevalence, nature and possible biopsychosocial aetiologies. Sleep Medicine Reviews, 13(6), 403–411. https://doi.org/10.1016/j.smrv.2009.02.003.

    Article  Google Scholar 

  • Vaughan, S., McGlone, F., Poole, H., & Moore, D. J. (In press). A quantitative sensory testing approach to pain in autism spectrum disorders. Journal of Autism and Developmental Disorders.

    Google Scholar 

  • Wager, T. D., Atlas, L. Y., Lindquist, M. A., Roy, M., Woo, C.-W., & Kross, E. (2013). An fMRI-based neurologic signature of physical pain. New England Journal of Medicine, 368(15), 1388–1397.

    Article  Google Scholar 

  • Williams, Z. J., Failla, M. D., Davis, S. L., Heflin, B. H., Okitondo, C. D., Moore, D. J., & Cascio, C. J. (2019). Thermal perceptual thresholds are typical in autism spectrum disorder but strongly related to intra-individual response variability. Scientific Reports, 9(1), 1–14.

    Article  Google Scholar 

  • Wing, L. (1976). Diagnosis, clinical description and prognosis. In L. Wing (Ed.), Early childhood autism (2nd ed.). Oxford: Pergamon Press.

    Google Scholar 

  • Wöhr, M., Orduz, D., Gregory, P., Moreno, H., Khan, U., Vörckel, K. J., Wolfer, D. P., Welzl, H., Gall, D., Schiffmann, S. N., & Schwaller, B. (2015). Lack of parvalbumin in mice leads to behavioral deficits relevant to all human autism core symptoms and related neural morphofunctional abnormalities. Translational Psychiatry, 5, e525.

    Article  Google Scholar 

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Moore, D., Failla, M.D. (2020). Pain in Autism Spectrum Disorders. In: Volkmar, F. (eds) Encyclopedia of Autism Spectrum Disorders. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6435-8_102488-1

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  • DOI: https://doi.org/10.1007/978-1-4614-6435-8_102488-1

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